Fifth Ave Perio

Improving Smiles

Guided Tissue Regeneration – What does it mean?

Written by: Dr. Clifford Melnick, DMD

Periodontal Bone Loss- What causes it?

Guided tissue regeneration or GTR is a surgical procedure which is routinely performed in our office. Periodontal disease is associated with chronic inflammation and bacterial infiltration under the gum line. When left untreated, the bacteria destroy the surrounding tissues and cause inflammation and bleeding. This is gingivitis. When left untreated, the gingivitis may progress to periodontitis which means that the bone is also involved and lost. This is due to the destruction by the bacteria themselves and the body in trying to fight the invading bacteria will destroy its own tissues. The net effect of this war zone going on below the gumline is bone loss around the teeth.

In areas of the mouth where the bone loss is more vertical in nature (imagine a “V”) whereby bone granules can be contained, we routinely pack the area with bone grafting…in our office we utilize bovine (cow) bone. It is extremely safe and has been successfully used on thousands of patients.

In a surgical site, there is always a race between the gum cells and the bone cells to fill a void. The gum cells always win the race because they migrate much faster than the bone cells ( 1mm/day). Guided tissue regeneration is a way to exclude the gum cells thereby allowing the bone cells to have a chance to migrate into the site and take root…no pun intended! So, what we do during surgery is pack the bone graft into the bone defect after thoroughly cleaning it out and then we drape the site with a specialized collagen membrane which prevents the downgrowth of the gum cells (epithelium). Then we suture the gum closed and the body does the rest. The collagen GTR membrane bio-resorbs or disintegrates in approximately 6 weeks after the procedure so there is no need to go back in to remove it as was needed in first generation membranes years ago.

Approximately 6 months after guided tissue regeneration is performed, x-ray evidence of new bone is often seen on radiographs and the gum pockets shrink dramatically to levels that are maintainable by the patient.

At Fifth Avenue Periodontics located in midtown manhattan, we routinely perform the GTR procedure for our patients. Please call us for an appointment at (212) 355-1266.